Breast Reduction

Breast reduction surgery is used to reduce the size and improve the shape of the woman's breast. It can correct such symptoms as breast, neck and shoulder pain, rash under the breasts, and back pain.

IS THERE MORE THAN ONE TYPE OF BREAST REDUCTION?

The procedure involves 3 steps: a reduction in the volume of the breast tissue, a reposition of the nipple-areola complex, and a reshaping of the breast skin. With modern techniques, it is unusual to require the actual removal and replacement of the nipple. Traditionally, breast reduction surgery was performed using an anchor shaped incision. The last 10 -15 years has seen a rise in the popularity of procedures such as the "L-shaped" and vertical reduction, which result in less visible scars on the breast.

WHAT TYPE OF ANESTHESIA IS REQUIRED?

Small breast reductions can be done as an outpatient under a local anesthesia with intravenous sedation. Larger breast reductions, however, require a general anesthesia and are usually performed in a hospital setting.

DOES BREAST REDUCTION SURGERY REQUIRE A HOSPITALIZATION OR IS IT AN OUT-PATIENT PROCEDURE?

Although breast reductions traditionally have involved a hospitalization of at least one night, many insurance carriers are now mandating that they be performed as an ambulatory procedure.

ARE BREAST REDUCTIONS COVERED BY INSURANCE?

The individual carriers make the decisions as far as coverage of breast reductions by insurance companies on a case-by-case basis. Some of the criteria used by insurance companies in making their decisions include the presence of symptoms such as back and shoulder pain and the estimate by the surgeon of the weight of tissue to be removed.

WILL I LOSE SENSATION AFTER THE SURGERY?

The loss of sensation after breast reduction can occur in a small percentage of cases and is related to the type of procedure selected by your surgeon. Fortunately, the procedures that are associated with the highest percentages of sensory loss – free nipple grafting- are rarely performed these days. On the other hand, the central mound procedure is, in my experience, rarely associated with loss of nipple sensation.

WILL I BE ABLE TO BREAST FEED?

One of the risks of breast reduction surgery is interference with the ability to breast feed. The patients in my practice who have undergone the central mound breast reduction and, subsequently, attempted to breast feed (although few in number) have done so successfully.

WHAT ARE THE COMPLICATIONS?

The most common complications of all surgeries included bleeding, infection, and hypertrophic and keloid scarring. Complications specific to breast reduction can include, but are not limited to, alteration in nipple sensation, loss of ability to breast feed, and the loss of all or part of the nipple and areola complex. Although these complications occur with a low frequency, they should be discussed with your surgeon.

WHAT WILL BE MY POST-OPERATIVE DISCOMFORT AND WHAT CARE WILL I NEED IF I GO HOME AFTER THE SURGERY?

Discomfort which is usually mild to moderate can be controlled with oral pain medication.

Light activities can be resumed as tolerated. Most patients return to work or school sometime at the end of the first week after the procedure. Aerobic activities can be resumed in about 3 weeks.

The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.